Getting Out of Hand

Nail Salons

The number of nail salons grew tremendously in the last few years and so has the incidence of infection and disease related to their use. Many diseases are increasingly resistant to treatment, and some salon workers are not following health regulations. The problem is exacerbated by too few health inspectors.

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Manicures and pedicures used to be add-on luxuries, exclusive to upscale hair salons. No longer. Today standalone nail salons are a $6 billion industry annually. There are about 50,000 nail salons nationwide, according to Professional Beauty Association, a trade group. That’s nearly quadruple the number of U.S. McDonald’s restaurants.

But, unlike a McDonald’s or other national chains where customers seek a consistent product at a constant price, delivered by uniformly trained employees, salons are as disparate as their clientele. Some salons charge $100 or more for a manicure-pedicure combo, while others charge about $20 for the same service. More important, levels of health compliance and performance vary from shoddy to superlative, and a more expensive treatment does not automatically translate to safer services.

State inspectors, who seek to enforce compliance and bust those who break the law, are stretched to the limit. There are too few inspectors to scrutinize the number of salons, leaving it a loosely monitored industry. The result? An unfortunate but significant increase in health risks. The good news is that you can still enjoy a safe manicure; many salons are well-maintained. But now more than ever, you must be on the lookout for problems that might jeopardize your health.

BEAUTY AND THE BEAST. If you think this is a lot of buzz over minor fungal infections, you are wrong. According to American Academy of Dermatology, health risks associated with the beauty industry now include viral infections, including HIV, herpes and hepatitis B and C. Many conditions and diseases are increasingly resistant to antibiotics. How can such a wide array of infection plague such a routine treatment?

During a manicure or pedicure, small breaks in the skin might occur. Also, unwitting clients might arrive at the salon with miniscule cuts. For example, women often shave their legs immediately before a pedicure, which actually makes their skin highly susceptible to staph bacteria found lingering in the drain of a salon’s whirlpool foot bath. Microscopic blood contact sets off an infection with other diseases. Doctors note that the hepatitis B virus can remain alive for up to 1 week on a manicure instrument that has microscopic blood particles on it. Beverly Hills, Calif., podiatrist Dr. Carolyn Siegal tells us that nearly each week she treats a patient with asymptomatic hepatitis symptoms that likely stem from a minor cut received during a recent pedicure.

In Florida for the fiscal year 2006-2007, the latest data available, inspectors issued 1,527 citations noting health issues to businesses. This was up from 1,367 citations in 2005-2006.

Some consequences, though extremely rare, are even deadly. For example, Texan Kimberly Kay Jackson died in February 2006 of a heart attack triggered by a staph infection, according to the Ft. Worth doctors who treated her. The infection occurred after Jackson developed an oozing wound that wouldn’t heal despite repeated rounds of antibiotics, the result of being cut on the heel by a pumice stone at a nail salon.

THE INVISIBLE MAN. Adding to health concerns is the scarcity of health inspectors. In California, 17 inspectors cover all 40,000 cosmetology outlets, which include nail salons, barber shops, hair salons and spas. “It is like the Wild West,” says Kevin Flanagan, spokesperson for California’s Board of Barbering and Cosmetology, which oversees nail salons. “It’s a big territory to cover.” How each state monitors nail salons varies. Oklahoma, for instance, has three to five inspectors who solely inspect nail establishments. Massachusetts has five inspectors (up from two in 2002), but those five must also investigate barber shops, hair salons and spas, which total about 8,400.

In Florida, 17 inspectors are responsible for checking 18,657 businesses that offer nail services. Each inspector will normally visit four to seven businesses per day, says Sam Farkas, spokesperson for Florida’s Department of Business and Professional Regulation, which oversees the state’s Board of Cosmetology. In the past year, Florida’s Board of Cosmetology decided that businesses need to be inspected only once every 2 years, instead of annually. Farkas says this was done to put more emphasis on visiting businesses that had previous violations.

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